A psychiatrist argues in books and on TV that drugs don't help
the mentally ill. His critics say he's crazy

By Christine Gorman--Reported by Alice Park/New York and Dick
Thompson/Washington

By some yardsticks, Dr. Peter Breggin seems to be a
successful--perhaps even influential--psychiatrist. He has
earned impressive academic credentials, published a string of
books and shown up on Today and The Oprah Winfrey Show. Many
patients rave about the doctor. "He's a wonderful person," says
one satisfied customer. "He cares so much about his clients. He
gave me the will to get better."

So why are so many other people saying such nasty things about
him? The head of the National Alliance for the Mentally Ill
calls Breggin "ignorant" and claims he's motivated by a lust for
fame and wealth. The former director of the National Institute
of Mental Health brands Breggin an "outlaw." The president of
the American Psychiatric Association says the doctor is the
modern equivalent of a "flat earther."

What causes these critics to lose their professional cool at the
mere mention of Breggin is his relentless crusade against the
conventional wisdom of psychiatry--and his increasingly high
profile. What causes Breggin to rail against his profession is
its eagerness to embrace technology, from the early zeal for
lobotomies and electroshock to the modern reliance on such
psychoactive drugs as Thorazine and lithium. In looking for the
quick fix, Breggin argues, too many psychiatrists have forgotten
the importance of love, hope and empathy in maintaining sanity.
The power to heal the mind lies in people, he says, not pills.

For many years no one paid much attention to Breggin, 58, but
that was before the dawn of the Prozac Age. The immense
popularity of the drug, which is most often prescribed for
depression but is gaining a reputation as an all-purpose
personality enhancer, has given Breggin his best ammunition yet.
In his new book Talking Back to Prozac (co-written with his wife
Ginger Ross Breggin), he says the drug is merely a stimulant
that does not get to the root of depression and is probably
dangerous when used over long periods. He has dumped on Prozac
in TV and radio debates with Dr. Peter Kramer, whose best seller
Listening to Prozac describes the drug's powers in generally
favorable terms. In the process, Breggin has infuriated Prozac's
manufacturer, Eli Lilly, prompting the firm to deluge
journalists with material intended to discredit the maverick
psychiatrist.

Breggin didn't start out to be a renegade. As his book jackets
proudly point out, his background is pure establishment: Harvard
College, Case Western Reserve Medical School, a teaching
fellowship at Harvard Medical School. But early in his career,
he became deeply disturbed by the treatment of psychiatric
patients, particularly the many long-term residents of mental
hospitals who spend their lives in a drugged-out state. In 1971
Breggin declared his rebellion, launching the Center for the
Study of Psychiatry in Bethesda, Maryland, as a way to push for
reform.

At issue is the very nature of mental illness. For the past few
decades, the majority of researchers have worked to show that
psychiatric disorders are triggered by chemical imbalances in
the brain that can be rectified with medication. Breggin, by
contrast, clings to an old-fashioned view: the emotional
problems that land a person on a psychiatrist's couch result
from traumas caused by outside forces, like sexual abuse during
childhood. Drugs can't erase these traumas, he asserts, and
aren't even appropriate for such severe conditions as
schizophrenia and manic depression. "These are not illnesses,"
he says. "They are ways people become when they are hurt or
frightened. The fact that something is extreme doesn't make it
an illness."

This bizarre notion takes no account of mountains of evidence to
the contrary. But, like a slick lawyer, Breggin has answers for
every argument. Researchers have, for example, observed
distinctive physical features in the brains of people with
schizophrenia. A study of identical twins found that one portion
of the brain was 15% smaller in the person with schizophrenia
than in the normal sibling. Breggin says the difference could be
the result of brain damage caused by the drugs given to control
the disease. Of course, it is difficult to test his hypothesis
because that would require studying people with schizophrenia
who are deliberately left untreated--a practice that most
psychiatrists would deem unethical.

Breggin is also a master of capitalizing on embarrassing lapses
in psychiatric research. Several times, scientific teams have
trumpeted the news that they have isolated a genetic marker for
manic depression. In all cases, the results could not be
replicated by others, and the conclusions were
withdrawn--something Breggin delights in pointing out at every
opportunity. Nor is he impressed by genealogical studies that
trace schizophrenia through several generations. "Things run in
families," he counters. "Speaking English runs 100% in American
families. It's not surprising that being emotionally upset would
run in families."

What galls psychiatrists most are Breggin's attacks on the
usefulness of antipsychosis drugs. He doesn't content himself
with describing possible side effects, such as uncontrollable
jerky movements and facial ticks, but claims the drugs rarely
have any benefit. He likens lithium, which is used to treat
manic depression, to lead and compares Prozac to amphetamines.

Breggin's preachments would be laughable, say critics, if they
weren't so dangerous. Though he warns his readers against
stopping their psychiatric drugs too abruptly or without medical
supervision, at least one schizophrenic man threw away his
medications after listening to Breggin on TV. The patient became
suicidal and was hospitalized for two weeks. "Breggin reinforces
the myth that mental illness is not real, that you wouldn't be
ill if you'd pull yourself up by the bootstraps," says Susan
Dime-Meenan, president of the National Depressive and
Manic-Depressive Association. "His views stop people from
getting treatment. They could cost a life."

The psychiatrist's credibility is not helped by the air of
flakiness that surrounds his life and work. Lilly regularly
links him to the Church of Scientology, which has long been a
rabid opponent of psychiatry. Breggin admits that he was once an
ally of the group and that his wife was a member. But he insists
they both renounced Scientology more than two decades ago.
Lilly, meanwhile, has combed through his old books and articles
in search of anything embarrassing--just like the conservatives
who used Lani Guinier's writings to scuttle her nomination to
serve in the Justice Department. In Breggin's case, his
opponents found a doozy: the doctor once wrote approvingly of
sexual relations between children. "I don't agree with that
anymore," Breggin says now, accusing Lilly of character
assassination. "That's from a period in the '60s, and I've
certainly left that far behind."

Unfortunately, what gets lost in the cross fire is any serious
consideration of Breggin's ideas. Amid extremely dubious
assertions like the notion that drugs don't help schizophrenics,
Breggin makes some points that many psychiatrists would agree
with. Among them: too many doctors prescribe drugs for minor
depression or anxiety without talking to patients long enough to
understand their problems. Too many patients look for pills to
smooth out the inevitable ups and downs of everyday life. And
powerful psychoactive drugs can indeed be dangerous if used
cavalierly.

It would be better if Breggin, the loudest voice making those
points, were less shrill and more reasonable. But then, the
calmer voices never seem to make it onto Oprah.